As part of the harm reduction work I do I deliver presentations at conferences. In 2016 I was asked to present at the National Substance Misuse Conference in Birmingham to support the need and adoption of drug consumption rooms (DCRs) in the UK as a way of reducing drug related deaths and drug litter. DCRs are places that people can use their drugs in a safer environment without the ever-present risk of overdose - the UK currently has the highest levels of overdose ever recorded.
Drug Consumption Rooms
Drug Consumption Rooms (DCRs) are controlled health care settings where people can more safely inject drugs under clinical supervision and receive health care, counselling and referrals to health and social services, including drug treatment.
There is overwhelming evidence that DCRs are effective in reducing new HIV infections, overdose deaths and public nuisance – and that they do not increase drug use or criminal activity.
To prepare for the talk I was given a tour of the city and the places that people publically inject in. This kicked off a longer term project looking at these spaces vulnerable people are using to administer their drugs.
Not Quite Public
Within sight of the local drug service
When we talk about people injecting in public spaces we don't acutally mean 'public'. These spaces are often just out of sight from public view, the same kinds of space that people use as a toilet at 2am on their way home from the pub. (Public injecting spaces are often also used as toilets.)
These spaces are often wastegrounds, unused areas or shaded doorways. The only thing for sure is that they are not hygienic spaces, often messy with poor light. They are not ideal for a place to inject.
Who Uses Here
People who are our most vulnerable, people who are homeless, young people hiding their drug use from their parents, people living in hostels that have a zero tolerance for drug use on the premises... whatever the reason it's rarely where people would choose to inject if they had a choice.
But... The Litter
Yes, these spaces are full of litter. The people using them are more likely to be stopped by the police and searched, they worry that syringes will be used as evidence. They might be hiding their drug use from parents/partners so carrying equipment around doesn't seem like an option.
But the litter also makes the spaces more risky for the people using there. All this used equipment increases the chances of a needle stick injury, increases the chances of getting a blood borne virus, and increases the chance that people using the space think this is the best that they deserve...
By accepting that we allow this to be the best option for people who are vulnerable injectors we are telling them that this is what we think they deserve. In the UK (and elsewhere) we give people sterile injecting equipment to reduce their harms, then send them out to inject in places we wouldn't feel safe to walk around.
Within sight of brand new Audi and BMWs
Sydney Medically Supervised Injecting Centre
One thing that has kept coming up during this project is the internalised stigma these spaces engender. For instance in Birmingham we found 'Skag Car Park' (skag being a derogatory term for heroin). In Swansea it was 'Junkie Jungle'... these are not the names given by the public, but by the people using them. This is the way people are seeing themselves.
A Better Way
Worldwide there are now well over 100 locations running drug consumption rooms. These are safer spaces, they are spaces that show people they have value and that we care if they are safe.
I'm planning to visit more DCRs (both official and underground services), and to visit areas that have significant public injecting issues. These images can juxtapose each other within this collection highlighting the difference in the ways we treat our most vulnerable people.
This represents a small selection of the images from this collection.
If you would like to find out more about the benefits of drug consumption rooms you may find the following links of interest: